Combating Racism and Place-ism in Medicine | J. Nwando Olayiwola | TEDxKingLincolnBronzeville

Summary

The speaker, a physician, reflects on how the medical profession has failed communities due to racism and placism. Using the stories of two friends, Wendy and Sarah, the physician highlights stark health disparities based on race and location. Wendy, a Black woman, faces systemic racism in healthcare, while Sarah, a white woman, experiences better care. The speaker advocates for dismantling racist and biased medical education, using technology to ensure equitable care, and empowering patients to demand better healthcare. The ultimate goal is to honor the medical oath to 'do no harm.'

Takeaways

• 🩺 The speaker, a physician, took an oath to do no harm and has dedicated their career to serving underserved communities, but acknowledges that the medical profession has broken its social contract due to racism and placism.
• 🏥 The speaker introduces two friends, Wendy (Black) and Sarah (White), who live only six miles apart but experience drastically different healthcare outcomes due to systemic racism and placism.
• 👩🏾‍⚕️ Racism in medicine results in Black patients, like Wendy, being taken less seriously by doctors, having their pain disregarded, and receiving lower-quality healthcare, leading to worse health outcomes.
• 🩹 Black women are significantly more likely to experience severe complications in pregnancy, higher infant mortality rates, and are less likely to receive life-saving interventions for heart attacks.
• 🏘️ Placism refers to the healthcare disparities caused by where a person lives, with zip codes and social determinants like housing, safety, and economic security heavily influencing health outcomes.
• 📊 Life expectancy disparities between wealthier and poorer zip codes in Ohio can be as much as 29 years, demonstrating the severe impact of placism on community health.
• ⚕️ Racism would continue to affect Wendy's health outcomes even if she moved to a wealthier area due to the pervasive influence of systemic racism on healthcare.
• 🎓 The speaker calls for changes in medical education to dismantle racist and biased teachings, replacing them with anti-racist, scientifically grounded approaches to care.
• 💻 Technology could be used to develop clinical decision algorithms that prompt doctors to address overlooked issues like pain management and hypertension, helping to combat racism and placism in real-time.
• 🗣️ The speaker urges patients to advocate for better care, institutions to retrain healthcare professionals, and doctors to honor their oath by providing compassionate, equitable care.

Q & A

What does the speaker mean by 'first do no harm' in the medical profession?

'First do no harm' refers to the medical oath taken by physicians, which emphasizes their responsibility to prioritize the well-being of patients and avoid causing harm. The speaker highlights that this oath has been compromised by systemic issues like racism and placism.

What are racism and placism in the context of medicine?

Racism in medicine refers to biased treatment based on race, leading to unequal healthcare outcomes for people of color. Placism refers to the impact of a person’s place of residence, or zip code, on their health outcomes, with certain communities receiving inferior healthcare due to systemic neglect and lack of resources.

How do racism and placism affect patients differently, as explained by the speaker?

The speaker contrasts the experiences of Wendy, a Black woman, and Sarah, a White woman, to show that racism leads to Black patients receiving less effective care. Wendy, for example, would be less likely to have her pain taken seriously and more likely to face higher mortality in childbirth. Placism means that Wendy’s zip code would determine a lower life expectancy compared to Sarah, who lives in a wealthier area.

What is the impact of racism on Black patients' experiences with pain management?

The speaker explains that Black patients, especially Black women, are often perceived as having a higher pain threshold, leading to their pain being ignored or undertreated by healthcare providers.

How does the speaker illustrate the differences in healthcare outcomes between Wendy and Sarah?

The speaker points out that despite living only six miles apart, Wendy, a Black woman, has a life expectancy of 68 years, while Sarah, a White woman, is expected to live to 84. This disparity is due to the combined effects of racism and placism, which limit access to quality healthcare for Black patients and those in poorer communities.

What solutions does the speaker propose to address racism and placism in healthcare?

The speaker advocates for two key solutions: reforming medical education to eliminate racist and biased practices, and leveraging technology to prompt healthcare providers to make anti-racist, equitable decisions in patient care, such as addressing untreated pain or using the best medications.

What is the significance of using technology in combating racism and placism in medicine?

The speaker suggests that technology can be used to create clinical decision algorithms that alert doctors to biases, reminding them to treat patients equitably. This could ensure that physicians address pain, prescribe appropriate medications, and consider the patient's living conditions (zip code) in their care.

Why does the speaker emphasize the importance of zip codes in determining healthcare outcomes?

The speaker explains that a person’s zip code often correlates with social determinants of health, such as access to quality housing, jobs, and safety. These factors greatly influence life expectancy and overall health, and are often ignored by healthcare providers.

How does the speaker suggest patients can contribute to improving healthcare equity?

The speaker encourages patients to take an active role in their healthcare by asking doctors to address their pain, inquire about appropriate screenings, and ensure they are receiving the best possible treatments for their conditions.

What role do institutions play in addressing the disparities in healthcare according to the speaker?

The speaker calls on medical institutions to retrain healthcare professionals, dismantle biased educational models, and teach doctors, nurses, and other health workers to be culturally empathetic and provide equitable care to all patients.